Wrapped in my own gratitude for my husband’s safe journey through a difficult surgery this week, I listened as another patient and another family struggled with a less favorable course. And my heart still hurts for this stranger. I will never see him again in all likelihood, but his trauma will play out thousands of times today across the nation and tens of thousands of times this year. And he never saw it coming.

Ten days ago, this patient now in a huge, highly respected urban medical center was living a normal life – or at least trying to. I heard his family say he had headaches for months that specialist after specialist seemed unable to diagnose. Nine days ago, he had a stroke.

I didn’t learn any of this by talking with the patient or his family. I just overheard it as my husband shared a room with him after they both had transferred out of the neuro-intensive care unit.

When he awoke, he was in a hospital bed, unable to move most of the left side of his body, and wearing an adult brief due to his inability to control bodily functions. His wife died some time ago, and at 60 years old, he is raising a teenaged daughter. Periodically, his daughter, his sister, her grown daughter, his twin brother and his niece would come to his room. Loud and a bit brash, they would call out orders to him to try to get him to move a limb or a finger or show some level of mental or physical activity that would point toward post-stroke improvement. He did what he could to oblige.

His sister announced that she was “the bull dog” of the family. She stated she was there to make sure he signed papers giving her legal authority over his daughter and his finances and that she would be in charge of next steps in the decision process for his medical care. His brother was obviously shaken by the whole scene but also obviously unable to change the pre-stroke dysfunction in the family.

When nursing assistants came to his room, they would chastise the patient a bit for being too modest to allow himself to be exposed as they checked his brief and tended to his linens. His mind and speech were sound enough for me to hear him repeat over and over again, “But my niece or my daughter could come in at any second.” To which the aides responded that he’d have to get used to the changes in his life. One time, the aides were mad at him because he had not urinated, as if his profoundly altered mental and physical status could be overcome by the will to do so.

Soon enough, a group of doctors came into the room. My husband and I were on the other side of the curtain that separated the two beds in the semi-private room, but we still could not avoid hearing the conversation. The doctors checked the patient and listened to the “bull dog” sister recount the night the family found her brother slumped in his chair after the stroke. The doctors also told the patient and his family that he’d not be discharged home but to a rehab facility – not the one where the doctors felt he’d get the best care but to one his insurance company and coverage would allow. The only question his family asked about that was if it was a longer distance from his house.

Soon, it was evening. It was just a few short hours later, and all the activity stopped. The patient’s family left. No more doctors. His food tray sat on his bedside table untouched until another aide came in. She asked him, “Why are you not eating?” There was silence. She stirred his mashed potatoes. She opened his juice carton. She told him he’d have to eat to get better. And she left.

My heart was about to break. I thought of what this man had already been through – months of headaches and a medical system so disjointed he was being tested stem to stern with no relief in sight, then a stroke (while alone in his home), waking to his brain and his body malfunctioning and wearing a diaper, listening to his family bicker and banter about details of his life going forward, hearing his doctors say he is going to a facility not because it is the best but because the insurance company says so, and finally having people wonder why he doesn’t feel like eating?

I did not know this man. I did not know his family. My husband’s course was much different – in part because of different physical issues and scenario, in part because he is lucky enough to have Medicare as his primary coverage and not a for-profit private insurance company, and in part because I live and breathe these issues in my working life. But still I was hurting for this man and for the thousands of patients across this country who are in the same leaking boat.

If any one of us thinks we’ll know exactly where we will be and with whom when illness or injury strikes us, we are delusional. It is enough to deal with the health event itself without all the other indignities. Unless each of us would like to be in this man’s situation, we have to address the systemic issues that force this inhumanity. Ask yourself, how hungry would you be? Would the mashed potato or the banana or anything else in the mechanized, soft diet seem important (that is really what they call it)? And 10 days ago, life was pretty normal for him.

We have to fight. We have to change this. So long as we start out by viewing patients as profits, all other issues will flow from that point. I am convinced of that. When we can view all patients as worthy of one single standard of high quality care then all other issues will flow from that spot too. Family dynamics are what they are. But even in those relationships, if the patient’s well being was valued above all else, the bull dogs might be less inclined to bite.

Support Medicare for everyone – not slicing and dicing Medicare. Because tomorrow or next week or a month from now, you could be the one lying in that hospital bed, in a diaper, waiting for others to decide everything for you. It would be better, in my view, if we protected ourselves beforehand.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.
http://www.commondreams.org/view/2011/07/06-2

Foking shame,reminds me of how my mother was treated.
God bless her soul.



The only, thing is..I stayed behind everynight,while all those other fokers left.

The older one gets the more people we bury and it makes us I think more careing. life is short and every day is a good day above ground and that we shouldnt tread on others and try to look out for them.

Thank you for responding and you are so right.When I wake in the morning,I will be another year older.Everyday above ground is precious.Although I seem to be a bit of both Bitter twards how the world is turning out on somethings,but thats JMO.I seem to also be more Humble on somethings.Have a Blessed day.
2K

I didn't realize you had a husband.

I dont...it made me think of my Mother..when she was in and out of the hosp. before she died.

I apologize for the confusion.

I was talking to Bestinshow.

One of the biggest problems with Americans: we spend more time shopping around for the new vehicle with the leather seats in the color we want than shopping for good insurance.

We are willing to spend 3/4 of our paycheck on a house we cannot afford, but are up in arms against spending money on insurance.

Insurance is expensive, why? Because health care is expensive. Why is health care expensive? Because of lawsuits, becuase of the cost of education/certification.

Nothing wrong with a single payer system, but it will not magically fix the core issues. A single payers system may thin the gap between insurance company profits and insurance prices by getting a better group deal, but will never touch the real core problems with the overall system of providing health care.

We must address malpractice liability, and we must address the rising costs of higher education.

Instead of paying for everyone's health care at the current inflated costs, we need to get those costs down first.

Instead of socializing medicine, we should socialize education. We need the best and brightest regardless of the wealth of there families. We need to stop making young students jump through a thousand hoops to get a good education.

This will dramatically effect the price of insurance, more doctors could make more money without raising there prices becuase they do not need to carry insane levels of malpractice insurance, and the pool of doctors would be larger due to cheap or free higher education, supply and demand. The more supply the lower the cots, this is FACT.

We cannot afford to fund health care for everyone given the current situation: fact, not without cutting SS or other entitlements.

It is like balancing your checkbook, you cannot do it without looking at why things cost what they cost and if you cannot afford it, you don't buy it.

No arguments . . . I guess no one disagrees with me?

Oh, I disagree with almost everything you said. It's socialist, which means the US Government will have to use force against it's own citizens to get them to behave the way they want. I don't believe that it's right for a Government to use force on it's citizens to enforce any agenda. You do. We'll never agree.

No, not so. I am not for mandates. You must have me confused with someone else.

If we are going to socialize anything education would bring down the cost of health care, doesn't mean I am for it. I am against big government.

Public Education is already socialized and it costs 40% more than private and private school graduates are much better educated than public school graduates. Socializing anything doesn't work. Healthcare, Education, etc.

When you said "Nothing wrong with a single payer system", you completely lost me. There are lots of wrong things about a single payer system. Read about wait times, read about how the patients are treated, read about mothers giving birth in hallways and elevators. People who are smart enough to be good doctors and nurses quickly find out that they can make more money in another field, so they flee healthcare, which leads to a shortage of doctors. There is everything wrong with a single payer system, which is why the rich from around the world come to the US for healthcare.

Group payer systems are not the problem. You are ignoring the points I was making by making generalized claims.

It is not who pays that makes it affordable or not affordable. That is the wrong question when asking what makes health-care affordable.

The fact that doctors go into dept ~300K dollars to get educated is a major problem. It is one of the reasons they charge so much for there services. The fact we put doctors through years of residency where they work 70-80+ hours a week is also a factor, that means less doctors, less doctors means higher prices for there services.

There are plenty of single payer systems that work without the problems you speak of . . . the examples I have seen however do not force doctors to get millions worth in malpractice, and also do not put them into dept like we do to get there education, they also do not have long residency programs where doctors are expected to work inhumane hours.

If we fix those problems, the cost of health-care would drop. How we fix it . . . I am agnostic about, I would prefer no government intervention myself, I am not in a position to know what is best, but seeing the problems is clear as day.

When you group up insurance it gets cheaper, you spread the risk, you really cannot argue against that, however it does not even come close to answering why health-care is expensive, it dodges the real problems with the American medical system.


I would like to see some statistics on this, I hear it often but honestly do not see very many foreigners in our hospitals. I work in the medical field, and so end up at hospitals all the time and do not see this.

Statistics?

------------------------------------

All that aside, what I would see happen would be the complete removal of medicare, medicaid, SS, welfare, and make higher education free.

Oh yea and cut military spending by half ASAP. Also allow people to opt out of most government programs, survival of the fittest, if a program offers services at competitive pricing, it will survive, and be funded by the people who do not opt out, if not enough people subscribe to the service becuase its junk, it will disappear. Free markets for the win.

That is what I think should be done, but if we arguing if insurance alone would be cheaper with group payers, then that is a separate specific topic, not what makes health care unaffordable, which is a supply demand, and efficiency conversation.

It costs a lot to train doctors, because they have to be trained by doctors. If you don't pay those doctors enough to teach, then they'll just be doctors and make more money. DUH.



Plenty? Name them.



There are extremely good reasons for the residents to work such long hours. They learn more by being in the hospital longer. There are fewer shift changes, which means fewer transitions in care. Also, hospitals are able to keep the costs of medical treatment down by having residents work long shifts. Also, it's prepares doctors for a life in which it's not uncommon to work 18-24 hour shifts.



WRONG! Government regulations make medical insurance expensive. It cannot be sold across state line. It has to covered numerous rare conditions that most people will never need. I don't want or need viagra! I don't need mammograms! I don't need or want a freaking sex change. Make it so that individuals can buy medical coverage from any provider and select what conditions they want covered and you'll suddenly see a huge decrease in price.



Google "Medical Tourism".



WHAT? You would give free education to everyone and watch people starve? I believe in a support system and I believe that if you want an education, you have to earn it by hard work and effort. The dropout rates are already extremely high in colleges. Why subsidize more of that?



I agree with cutting military spending, but why in half? How do you know that won't leave us defenseless? Is this just a number you pulled out of the air? Why even include this?



Most government programs have no constitutional basis and therefore should be eliminated immediately.

It would honestly take too long to respond to some of the things you have said here Spider.

Insurance in and of itself does not require the hoops government has put in place, so we can agree that the current state of affairs are do to government placing undue burdens on the system not becuase group insurance is bad in and of itself.

However about residency, this topic has been studied by people far more involved than me or you, and the studies show people who are sleep deprived DO NOT learn more just becuase they spend more hours trying to learn: FACT. Work smart not hard.

Please explain why free college for everyone would cause people to starve? The current system puts undue strain on young people to jump through legal hoops when they should be studying there chosen field. I know I spent weeks reading about financial aid, and applying to ultimately get pennies on the dollar for the true cost. We have people on the university pay role who's only job is financial aid, what a waste!

Germany provides almost free higher education and they are doing quite well. How does that compare to what you envision?

1) Those Universities are hard to get into.
2) They are poorly ranked internationally.
3) The US Government does not have the authority to do this.

seriously? I take it you didnt read the original post yet felt the need to comment?

If you had read the post you would see that at the end of the article it read.

"Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign."

Please in the future have something to say that is at least informed or
ignore the topic if you do not have an informed opinion.

What collage did you attend anyhow?

Sure we can afford it if we cut out the profit makeing middlemen. Other countries have done this with smaller economies its simply a matter of priorities.

We can cut military spending and aid to other countries for starters.

We have the most expensive healthcare in the world yet rank something like 23rd in terms of care.

This tells me that if we remove the profit factor and apply it to care we can have the best healthcare in the world and other people will not profit off of our illness.


It realy is pathetic that the capitalists even turn a buck when we are dieing of cancer.

I agree. I lived for ten years in a country that has socialized medicine (Sweden). All medical and dental for children is free, including prenatal, birthing and postnatal care for the mother. I had my next youngest daughter in the USA in 1994 and it cost me $15k just for the birth (c-section); I had my youngest daughter in Sweden, received BETTER care and the ENTIRE deal cost me $11 a day for the hospital stay and food.

There is a ceiling there on salaries. Doctors, lawyers and dentists cannot extort unbelievable amounts of money for their services. That leaves only the people who TRULY want to make a difference instead of getting rich from other people's woes. I have NEVER seen anyone made to wait too long or babies born in hallways. BTW, the doctors there work a regular 40 hour week - and there are PLENTY to cover the shifts.

Dental care for children is free, and so people tend to keep their teeth well into their dotage. My late MIL was 75 when she died; she had most of her teeth and they were in great condition .. this is common.

Sweden is number 2 on the list of highest quality of living in the world and their infant mortality rate is MUCH lower than that of the USA. As a matter of fact, Sweden ranks 4th in the world for surviving children per 1000 births, while the USA only ranks 34th.

The news always covers the horrors of socialized medicine (which seem to be in England) but it never reports about the places where it works. Our media controls with hysteria and more often than not, it's in the government's pocket. Government actually does not want socialized medicine here because it WOULD cut out the middlemen and their big kickback profits.

It's not difficult to be accepted in the colleges there, either. You must, of course, be fairly proficient in Swedish. But there are school exchange programs and I even know of some Canadian Bible schools that operate there.

Thank you for posting your first hand experience. I do not even understand why there is even a debate on this between the dems and repugs unless they are both in the pocket of the pharmicutical companies.

Its disgracefull that there is a debate on healthcare its a no brainer if we pretend to be a descent society.

I have a great healthcare plan through work and they cover us for two months in the event of a layoff, however I was laid off for three months a few years ago and was without insurence for a month.

I was verry fearfull for myself and my children.